Thoracic Radiology of Infections Emerging After Natural Disasters

Companion Animals Welfare in Non-Epidemic Emergencies: The Case of Central Italy, Post-Earthquake 2016/2017

Among the several factors affecting animal welfare, non-epidemic emergencies are very stressful events. In the aftermath of earthquakes or during flooding, snowstorms and wildfires, companion animals are subject to injuries and deep stress, abandonment or loss resulting in the overcrowding of animal shelters, or in emergent free-roaming populations representing a potential public health threat to the affected communities. The loss of animals often also results in significant psychological trauma for their guardians. For these reasons in all phases of calamities, the care of companion animals becomes essential. This paper describes the activities that were carried out for the veterinary care of dogs and cats affected by the earthquakes that occurred in central Italy from August 2016 to January 2017. These disasters provided an opportunity to test an integrated emergency management system in which several actors participated to aid, assist and accommodate the companion animals, whether owned or strays, affected by the catastrophic events.

Radiology of Chronic Cavitary Infections

Chronic cavitary lung disease is an uncommon manifestation of pulmonary infection, and is a pattern which worldwide is most commonly caused by reactivation tuberculosis. Other organisms, however, can cause similar radiologic patterns. Endemic fungi have long been recognized as potential causes of this pattern in North and South America, but the frequency with which these diseases present with chronic cavities in North America is relatively small. Nontuberculous mycobacteria and chronic aspergillus infections are recognized with increasing frequency as causes of this pattern. Melioidosis, a bacterial infection that can also cause chronic lung cavities, was previously understood to be relevant primarily in Southeast Asia, but is now understood to have a wider geographic range. While cultures, serologies, and other laboratory methods are key to identifying the infectious causes of chronic lung cavities, radiologic evaluation can contribute to the diagnosis. Differentiating the radiologic patterns of these diseases from reactivation tuberculosis depends on subtle differences in imaging findings and, in some cases, appreciation of underlying lung disease.

Pulmonary Leptospirosis With Diffuse Alveolar Hemorrhage: High-Resolution Computed Tomographic Findings in 16 Patients

OBJECTIVE

The aim of this study was to evaluate the high-resolution computed tomographic (HRCT) findings from patients with leptospirosis and diffuse alveolar hemorrhage (DAH).

MATERIALS AND METHODS

We retrospectively reviewed HRCT findings from 16 patients diagnosed as having leptospirosis causing DAH. The patient sample was composed of 13 men and 3 women aged 22 to 53 years (mean age, 34.5 years). Diagnosis was established with confirmation of leptospirosis infection by serologic microagglutination test. Histopathological study was performed in 8 patients. Two chest radiologists analyzed the HRCT images and reached decisions by consensus.

RESULTS

The predominant HRCT findings were ground-glass opacities and airspace nodules (both n = 12, 75%), ground-glass nodules (n = 9, 56.25%), consolidations (n = 7, 43.75%), "crazy-paving" pattern (n = 3, 18.75%), and interlobular septal thickening without ground-glass opacity (n = 3, 18.75%). Bilateral pleural effusion was an associated finding in 2 (12.5%) patients. Analysis of the axial distribution of the lesions revealed diffuse distribution in 11 (68.75%) patients and peripheral lung zone predominance in 5 (31.25%) patients. Abnormalities were bilateral in all 16 (100%) patients. Analysis of the craniocaudal distribution of the lesions revealed lower zone predominance in 9 (56.25%) patients, diffuse distribution in 5 (31.25%) patients, middle zone predominance in 1 (6.25%) patient, and upper zone predominance in 1 (6.25%) patient.

CONCLUSIONS

The most frequent HRCT findings in patients with leptospirosis causing DAH were ground-glass opacities, airspace nodules, ground-glass nodules, and consolidations. The lesions showed symmetrical distribution with lower zone predominance in most cases.

Challenges Encountered During the Veterinary Disaster Response: An Example from Chile

Simple Summary

Disaster preparedness for companion animals has economic, social and welfare benefits, yet many countries continue to omit dogs and cats from their national and regional contingency planning. Responses therefore, are often chaotic, inefficient and uncoordinated, or absent altogether. Documented experiences in Chile contribute to the information supporting the inclusion of companion animals into locally relevant disaster plans. These plans serve to prepare communities and authorities, identify resources available, establish a chain of command, develop local priorities, and subsequently reduce the negative impacts on both human and animal communities.

Abstract

Large-scale disasters have immeasurable effects on human and animal communities. Evaluating and reporting on the response successes and difficulties encountered serves to improve existing preparedness documents and provide support to those in the process of developing plans. Although the majority of disasters occur in low and middle income nations, less than 1% of the disaster literature originates from these countries. This report describes a response to a disease outbreak in domestic dogs in Dichato, Chile following the 2010 earthquake/tsunami. With no national plan coordinating the companion animal response, there was a chaotic approach among animal welfare organizations towards rescue, diagnosis, treatment and record-keeping. Similar to the medical response following the 1985 earthquake near Santiago, we experienced problems within our own teams in maintenance of data integrity and protocol compliance. Loss of infrastructure added complications with transportation, communications and acquisition of supplies. Similar challenges likely occur in most disasters, but can be reduced through pro-active planning at national and local levels. There is sufficient information to support the human and animal welfare benefits of including companion animals in national planning, and lessons learned through this and other experiences can assist planners in the development of comprehensive and locally relevant contingency plans.

Review of the Risks of Some Canine Zoonoses from Free-Roaming Dogs in the Post-Disaster Setting of Latin America

Simple Summary

Free-roaming dogs are seldom considered an important public health risk following natural disasters in developing regions. With the high number of recognized canine zoonoses and evidence of increased transmission of some significant diseases this is a risk that may be being overlooked. Communities with free-roaming dogs and endemic canine zoonoses of importance should be developing appropriate community preparedness and response plans to mitigate the occurrence of increased transmission following disasters.

Abstract

In the absence of humane and sustainable control strategies for free-roaming dogs (FRD) and the lack of effective disaster preparedness planning in developing regions of the world, the occurrence of canine zoonoses is a potentially important yet unrecognized issue. The existence of large populations of FRDs in Latin America predisposes communities to a host of public health problems that are all potentially exacerbated following disasters due to social and environmental disturbances. There are hundreds of recognized canine zoonoses but a paucity of recommendations for the mitigation of the risk of emergence following disasters. Although some of the symptoms of diseases most commonly reported in human populations following disasters resemble a host of canine zoonoses, there is little mention in key public health documents of FRDs posing any significant risk. We highlight five neglected canine zoonoses of importance in Latin America, and offer recommendations for pre- and post-disaster preparedness and planning to assist in mitigation of the transmission of canine zoonoses arising from FRDs following disasters.

Imaging spectrum of thoracic melioidosis

Melioidosis is predominantly a tropical disease caused by Burkholderia pseudomallei, a soil-dwelling gram-negative, aerobic bacillus that is distributed primarily in southeast Asia and northern Australia. In this pictorial essay, we provide an illustrated review and conceptual framework of the protean imaging features of this infection, along with a brief description of its clinical manifestations and demographic features.